脑损伤治疗

目的：预防并发症，促进功能恢复，使患者具有较好的独立生活能力。

Objective: to prevent complications and promote functional recovery, so that patients with better independent living skills.

最大保护期 Maximum protection period

1、应用Bobath技术进行早期的抗痉挛体位护理。Bobath技术主要特点：利用关键点的控

制及设计的反射抑制模式和良好肢体摆放来抑制痉挛。

the application of Bobath technology for early anti spasm posture nursing. Bobath technology main features: the use of key points of control and design of the reflex inhibition mode and good limb placed to inhibit the spasm.

2、必要的药物和手术治疗对重型患者除保持呼吸道通畅外，尚可用①脱水疗法②冬眠低温

疗法③肾上腺皮质激素④改善脑代谢的药物。⑤高压氧治疗

essential drugs and surgical treatment for patients with severe respiratory tract in addition to maintain airway patency,besides,①]dehydration therapy ②]hibernation therapy③adrenal cortex hormone④Drugs to improve brain metabolism

⑤Hyperbaric oxygen therapy

3、营养支持疗法：昏迷患者给高蛋白质，高热量饮食。保持水，电解质平衡。

nutrition support therapy: coma patients to high protein, high calorie diet. Maintain water, electrolyte balance.

文献：高压氧（HBO）对脑外伤的治疗效果确切，且越早治疗效果越好。方法：空气加压舱加压，治疗压为0.2mpa，加压20min，减压20min，稳定吸氧70min，中间舱内空气10min，每天治疗一次，每周连续治疗5d，休息2d，10次为1个疗程，连续4个疗程。（刘景昌，高压氧治疗基本原理及其对机体的影响||杨益，主编.高压氧治疗基础与临床.上海：上海科学技术出版社.)

动作控制期 Motion control period

1、对患者肢体采取ROM训练：被动运动（应用肢体功能训练器进行肢体被动运动）

the patient's body to take ROM training: passive movement (Application of limb function exercise for the body of the passive movement)

2、肌肉牵拉技术，按摩肢体，促进血液循环

muscle pull technology, massage the body, promote blood circulation

3、促醒治疗：音乐语言刺激，按摩与软毛刷刺激，光电刺激，生活护理刺激。

Resuscitating therapy: music language stimulation, massage and soft brush stimulation, photoelectric stimulation, stimulation of life care

4、利用滑轮、悬带，由健侧肢体拉动滑轮帮助患侧肢体进行抗重力训练，以促进关节功能和肌肉力量的恢复。

u se pulley, sling, by the contralateral limb pulling pulley to help affected limb anti gravity training, to promote the recovery of joint function and muscle strength.

5、传统康复：每日进行合谷、内关、印堂、百会等针刺治疗。（中华物理医学与康复杂志)

The traditional rehabilitation: Daily Hegu, Neiguan, Baihui, Yintang acupuncture treatment

6、改善肺功能:呼吸训练和手法排痰

improve lung function: breathing training and manipulation of sputum

功能恢复期 Functional recovery period

1、运动障碍：鼓励患者主动参与肢体康复训练（应用PNF技术和Rood技术，Brunnstrom 技术）

Motor disorders: patients are encouraged to participate in physical rehabilitation training (PNF technology and Brunnstrom technology, Rood Technology).

1，床上训练（关节被动活动一天3次，每次半小时；床上主动运动，桥式运动；体位转换及平衡训练，翻身，坐起；蹬空屈伸运动；患肢摆动法；内外旋转法；屈髋开

合法，俯卧开合法。）

bed training (joint passive movement three times a day, every half an hour;

bed active movement, bridge style movement; convert position and balance training, turning over, sit up; TiC empty flexion and extension movement; limb swing method; internal and external rotation method; flexion of the hip open legal, prone to open legal.

2，俯卧位训练position training

3，跪位训练kneeling training

4，坐位训练（坐位屈髋法，坐位开合法） seat training (seat hip flexion, open legal seat)

5，爬位训练climbing training

6，站位训练（站位扶物下蹲法，站位患肢摆动法，站位内外旋转法）

train stations (stations help things squat, limb swing stance, stance and rotation)

7，作业疗法（套圈，木钉板）Operation treatment(ring, pegboard)

8，Lokomat机器人辅助步行训练（至少每次30分钟的训练，每周3次，持续4～8周，并且定期评估以确定是否需要进一步训练以达到效果。

Lokomat robot assisted walking training (at least 30 minutes each time,

3 times a week, for

4 to 8 weeks, and regular assessment to determine whether

the need for further training to achieve results.

2、吞咽障碍：患者恢复主动进食功能时，应该鼓励和训练患者吞咽和咀嚼功能。swallowing disorders: patients should be encouraged and trained to swallow and chew with the function of active eating.

3、言语障碍：创造良好的言语环境，及时纠正异常的发音。根据其失语症或构音障碍的表现采用口、咽、唇、舌及肺活量训练等。

language barrier: to create a good language environment, to correct the abnormal pronunciation. According to the aphasia or dysarthria performance by mouth, pharynx, lip, tongue and vital capacity training.

4、认知障碍：治疗性作业活动cognitive impairment: treatment of sexual activity

1，注意力和集中力的康复训练方法（猜测游戏，删除作业，时间感，数目顺序，代币法）attention and concentration of the rehabilitation training methods (guessing game, delete operations, sense of time, the number of order, token method)

2，记忆能力的康复训练方法（视觉记忆，编故事法，地图作业，彩色积木块排列）the memory ability of the rehabilitation training method (visual memory, the story method, map operation, color block arrangement)

3，思维能力的康复训练方法（指出报纸中的消息，排列数字，分类）

the thinking ability of the rehabilitation training method (points out the